Poetry, Art, Medicine & Society

Health Care: A Roentgenogram

Daniel Haller, Julius Mackie, William Powlis—these three men saved my life. I was 25 and in my final year of medical school. I’d had a nagging cough for several months and my friends urged me off and on to get a chest X-ray, check it out, though they half laughed when they told me. No one, I least of all, imagined anything would turn up. I was interested in radiology at the time. It seemed like a good specialty. New technology and a growing field—MRI was really taking off—great hours, a residency that wouldn’t kill me with years and years of on-call, plus I really liked it and was pretty good at reading films. So when I put my own chest film up on the light box the last thing I expected was a large mass—as we call things that shouldn’t be in a person’s body. The word has such connotations of size and weight, Newtonian physics, a cold, precise world where everything ends predictably.

Fortunately, Dan Haller, my oncologist, told me I had Hodgkin’s Disease, a “good” cancer to have, because it was always treatable and usually curable. He put me through the drill of tests and scans, including a special form of torture no longer practiced called a lymphangiogram, where dye is inserted with needles in the webs of your toes. Julius Mackie cut me open, took out my spleen, and assorted lymph nodes— a “staging laparotomy” to determine the spread of the disease and guide treatment. Then he sewed me back up. I was not an easy patient. When the surgery residents gathered around me in my room on the med-surg floor, I told them I thought I might have an obstruction. I was still woozy from the morphine, but I knew everything, which means I knew too much, and was sure I’d suffer all the complications. Most medical students were part-time hypochondriacs. You couldn’t read about so many terrible diseases and take care of people afflicted with them and not become infected with a little fear, a little irrational fatalism. In my case, an overactive imagination had actually produced results. But somehow, despite my elaborate concerns, I recovered from the surgery unremarkably and began my radiation treatments.

When I inscribed my first book, Plums & Ashes, for Bill Powlis, my radiation oncologist, years after he cured my cancer, I wrote that aside from my parents, he was the person most responsible for my being in the world. About this, there is no exaggeration. Although rare, Hodgkin’s disease had been inexorable, a death sentence for children and young adults until its modern treatment with radiotherapy (and/or combination chemotherapy). Bill Powlis was and is a master of that field. He is a remarkable physician, fully informed and proficient, gentle, good natured, unflappable, an excellent listener, and a great teacher, which is so important because all patients, not just medical students, have much to learn if they are to collaborate effectively in their own recovery. There’s a lot to know when it comes to cancer treatment, and the stakes are high. Fortunately for me, I was treated by one of the best and at one of the best institutions in the country, the Hospital of the University of Pennsylvania.

Even then, I found it a difficult road. I wore a hat religiously in an effort to hide the back of my scalp where my hair fell out. More than once I had to explain to someone (in a whisper) why my head remained impolitely covered indoors. The actual treatment took only a few seconds. But the whir of the machine casting its high-energy beam promised that a few hours later, with clockwork punctuality, I would become sick to my stomach. And the treatments followed a workaday schedule, Monday through Friday, for months. Nonetheless, I tried to go on with my life. I changed my residency plans—decided to go into pathology instead, less on-call, and I could do research, pursue poetry as a dual ambition. I sat in on Daniel Hoffman’s graduate writing seminar on the other side of campus, telling him in confidence that I would have to leave early each session, so I could get back to my apartment before the nausea kicked in. Only once did I mistime my exit, though I don’t think I’ve ever felt so wretched in my life, before or since, even during my initial diagnosis, when cancer transformed me from indestructible hot-shot proto-doctor into one of my on-call “admissions” lying on a gurney. I’d loitered, to toss in my two cents about an interesting poem, and didn’t quite make it home. It was February, and I bent over between the ATM and the convenience store in my gray parka while passersby tried to ignore me, just another drunk or homeless person in the snow…to be continued

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David Moolten

About me: I'm the author of three books of poetry, Plums & Ashes (Northeastern University, 1994), which won the Samuel French Morse Poetry Prize, Especially Then (David Robert Books, 2005), and Primitive Mood, which won the 2009 T.S. Eliot Prize from Truman State University Press, and was published in 2009.

I'm also a physician specializing in transfusion medicine, and I live, write and practice in Philadelphia, Pennsylvania.

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Audio Files

'Cuda(Originally appeared in The Kenyon Review)

Ode For Orville And Wilbur Wright(Originally appeared in The Southern Review)

Ode For Orville And Wilbur Wright

I don't yearn for their steep excursion
Into fame and fortune, for it had
The usual price, and Orville died bitter
And Wilbur died young. I envy them
Only the slender and empty distance they left
Between them and a seaside's grassy bluffs
In mild December, the frail ingenuity
Of dreams, a lifetime's hopes made of string and cloth
And a little puttering motor that might have run
A lawn mower if the brothers had put their minds
To one first. For dumb exhilaration, nothing --
Not an F-16 thundering from its base
In Turkey nor my redeye circling O'Hare --
Comes close to what they must have felt
For less than a shaking, clattering minute
Clearing all attachment to the world
Of dickering and petty concerns: for some
No other heaven. So I take note of them
As they took notes from the lonely buzzard, obsessed
To the point of love with the ghostly air
And the small fluttering things that wandered
Through it. Eccentric but never flighty,
Bookish but not above nicking their hands
In bicycle shops and basements, they lived
With their sister and tinkered with the future.
Propelled by ambition, the mandate
It invents, they still heeded the laws
Of nature, trimmed needless weight, saw everything
Even themselves as burden, determined
Not to crash and burn. Sheer will launched them,
Good will, because those first forty yards
Skimming shale and reeds were for everyone.
Face down between the struts, staring at the ground
As it blurred past, they failed like anyone
To grasp the implications. But legs flailing
They hung on, buoyed by never and almost
And then just barely. I could do worse
Than their brief rapture, their common sense
Of purpose. Or I could, if only
For a moment, exalt them, go along
With the jury-rigged myth, the quaint
Contrivance that lets them rise above it all.

Readers of the Literature, Art & Medicine Blog may remember me as the first Artist in Residence at NYUSOM, or as the creator and teacher of Art & Anatomy in the Master Scholars Program in Humanistic Medicine [previously] [interview]. You may have seen my own or my students' work on […]

In a small off-Broadway theatre in NYC, it’s opening night for a new play, The Absolutely, Positively, Forget About it, Last Night at Von Dahm’s Sports Bar, Wing Hut and Karaoke Palace. The actors run through their lines one last time before heading to wardrobe, the props are on set, […]

about.me

Head & Feet In The Clouds

O.k. so here goes. I'm a poet, a very fledgling filmmaker, and a doctor, pretty much in that order (except when it comes to keeping the lights on).

My most recent book of verse, Primitive Mood, won the T.S. Eliot Prize from Truman State University Press and was published in 2009. I also have two previous books, Plums & Ashes (Northeastern University, 1994), which won the Samuel French Morse Poetry Prize, and Especially Then (David Robert Books, 2005). My poems have appeared in magazines too (such as Poetry, The Georgia Review, The Kenyon Review, The Southwest Review, and Epoch, among others). Last but not least, I've had the good luck to see work in anthologies, including a Pushcart Prize.

The movie list is short, though I hope to make it longer...I've finished one: "Astronaut Goes From Migrant Fields To Outer Space," a short film featuring video, animation, and spoken word, which screened nationally at festivals.

My medical specialty is transfusion medicine, which means I'm an expert on the collection, storage and use of blood (and associated therapies and technologies) for patient care.